Stomach Pouch You Can’t Get Rid Of?

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You may have a condition called Diastasis Recti

Stomach Pouch You Can’t Get Rid Of?Did you have your children a few years ago? Many years ago? But still notice…a pouch? Maybe you exercise every day.  Maybe you do 100 crunches a day.  Perhaps you run, bike or do some kind of cardio on a consistent basis, but still notice that you can’t get rid of that belly fat? I am here to tell you that it may not be fat at all.  You may have a condition called ‘diastasis recti’.  Sounds scary, doesn’t it?  It’s not! And it’s fixable!

Your core is essentially wrapped in muscle. You literally have a muscular corset.  Picture it. If a corset is tied nice and tight, your trunk would feel pretty stable, wouldn’t it? (You might not be able to breathe, but at least you are stable and you look good! What we women do for fashion…) Now, imagine if the corset is not tied very snug.  If the laces are loose, you wouldn’t feel stable.  The corset may be buckling in the back and sticking out.  It would not be maintaining your shape very well.

This is the case with your trunk.  There are muscles surrounding your core. Your ‘6 pack abs’ are made of a muscle called the rectus abdominus.  The ‘cubes’ of the 6 pack are on opposite sides of a structure called your linea alba.  This is a connective tissue structure that runs straight down from your sternum to your pubic bone.   Maybe you remember when you were pregnant that this line on your skin possibly became a little darker during the pregnancy.  The deep linea alba is made up of connective tissue that is composed of collagen.  During your pregnancy, there is a hormone called ‘relaxin’ that gets released and affects all connective tissue/collagen in your body.  Are you still with me? Keep following, it will all make sense!  The hormone relaxin does just that—it relaxes.  Ideally it would just target the connective tissue in your pelvis to allow the baby to drop and be delivered. However it is systemic and affects all the connective tissue in the body—including the linea alba.  Once this structure gets weak, the 6 pack abdominal muscles start to separate.   If they separate too much, then you develop the condition called ‘diastasis recti’.

NORDSTROM.comThe separation of the abdominal muscles can cause different problems in your body.  Because the corset is disrupted, you can develop back pain.   Since the corset is not tied tightly, your low spine is no longer supported.  This back pain can get progressively worse over time.

Also, since the corset is not tied very snug, the linea alba area can protrude.  This can look different on different people.  It may look like a pouch, a bulge, a midline ridge or a point sticking out near your belly button.   This protrusion would appear when you are trying to engage your abdominals.   Perhaps when you try to sit up from a laying down position or when you try and perform an abdominal crunch.

Ok, so now you may have figured that you have this condition—what now?  Here are some do’s and don’ts:

The Don’ts:

  1. Do NOT continue to do sit-ups/crunches. These types of exercises split the abdominal muscles even more.   Leg lifts, crunches, exercises for the obliques—all of these exercises can split the abdominal muscles more.
  2. Do Not lose hope! I have worked with women who have kids in college and have corrected this condition.


  1. Learn how to recruit your Transversus Abdominus muscle. This is a deep abdominal muscle that when engaged properly, can close the gap of the linea alba and other abdominal muscles.   This muscles is incredibly hard to find and isolate, but work with a trained professional (women’s health physical therapist, personal trainer, etc) and you will be strengthening this muscle in no time.
  2. Use proper body mechanics. Try not to sit up straight from a laying down position.  Turn to your side first and use your hands and elbows to push yourself up.  Remember the more you improperly engage your abdominals, the worse the condition can get.
  3. Wear a brace. Not a corset!  There is a brace called a Tupler brace created by a clinician named Julie Tupler.  It is a splint that criss crosses in front of the abdomen and helps keep the borders of the 6 pack muscles together.  You can wear this brace during the day while you are performing your daily activities.   You can take it off to sleep.  The more conditioned your muscles get, the less you can wear the brace.


This is not a hopeless condition.  I have seen great results working with women who have been diligent about their exercises and body mechanics.   It is possible to get rid of that pouch and have a flat tummy.  Seek out the expertise of a women’s health physical therapy specialist.   Work hard, don’t stress and you’ll be wearing a teeny bikini in no time!


  • Denise Jagroo

    Dr. Denise Jagroo is a Board Certified Clinical Specialist in Women's Health Physical Therapy. She is the author of Your Best Pregnancy: The Ultimate Guide to Easing the Aches, Pains and Uncomfortable Side Effects During Each Stage of Your Pregnancy. She is a national lecturer and has a private practice in midtown NYC. She is also a contributor to Glow Beauty Magazine. Visit her at:

1 Response

  1. Janice Ashby says:

    I have this and have researched solutions. When you reach your late fifties and beyond the suggested dedicated exhaustive exercise routines are no longer practical or appealing. Fixing the condition surgically is considered cosmetic and seems mainly the domain of plastic surgeons or some general surgeons. Their tummy tuck solution appears to be the only effective treatment to rid oneself of this ugly protrusion on my otherwise slim frame.

    But tummy tucks are terribly expensive, incredibly painful with a three to six month recovery period. Therefore out of the question for busy, cowardly me. Boo hop. Why did no one warn me this might happen in my thirties when I would have taken appropriate ab strengthening exercises to prevent it happening?

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